Abstract
BackgroundAims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span.MethodsData and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate.ResultsThree patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 ± 13 vs. 28.2 ± 21; p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56; p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15; p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography.ConclusionsEstimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group; there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care.
Highlights
Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span
In the pandemic group, 3 patients developed COVID19 infection during hospital stay resulting in an estimated COVID-19 infection-free rate of 98% (Fig. 2)
The present analysis has shown that the measures applied to maintain thoracic surgery activity at our university hospital involved as a primary COVID-19 treatment Institution, resulted in an estimated COVID-19 infection-free rate of 98%
Summary
Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span. During the COVID-19 pandemic, patients’ risk of inhospital contagion had to be weighed against prognostic worsening following surgical or medical treatment delay or cancelation [4, 5]. In several hospitals, a significant number of thoracic surgery procedures have been canceled or postponed as well. Our university policlinic became the 2nd most important COVID-19 hospital in Rome, the hospitalization policy has been rearranged in order to continue to treat patients requiring urgent surgical care while minimizing risks of in-hospital contagion. Since thoracic surgery activity is mainly devoted to treat oncological diseases including lung cancer, which is one of the more frequent malignancy worldwide, the risk of delaying or negating prompt therapy to a meaningful number of patients has become real during the pandemic
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